It is clear that patterns of systemic fluoride intake by children in the United States have changed in the last several decades. These changes are responsible in part for the decline in caries prevalence in populations not drinking fluoridated water. The most conclusive evidence of such changes is the observed increase in the prevalence of very mild and mild fluorosis in the non-fluoridated population. In view of these observations and other evidence, it has been stated repeatedly that current recommendations concerning the fluoride supplement dose, concentrations of fluoride to be used in drinking water, and concentrations of need was a major theme of the 1989 fluoride symposium sponsored by NIDR. The need has become more urgent as a result of public concern related to the prematurely released data from the NIEHS fluoride toxicology study. The specific aims for the workshop proposed in this application are: (1) To provide a comprehensive review of data and implications related to changing sources and patterns of systemic fluoride intake in the United States; (2) To determine if the currently approved fluoride supplement dose schedule should be revised and, if so, to recommend a new schedule; (3) To determine if the currently approved recommendations concerning optimal levels of fluoride to be used in public water supplies should be revised and, if so, to develop new recommendations; (4) To develop recommendations concerning the maximum concentrations of fluoride to be contained in various topical fluoride agents. The workshop is to be held in Chapel Hill, N.C., April 22-24, 1991.